Degrees of Transparency

By John Gallagher

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When Bridget Bush, MD, an anesthesiologist at Optum Care Washington (formerly The Everett Clinic), meets with patients, they know at a glance that she has a medical degree. “Right now, my badge says my last name, and it does say ‘MD’ underneath in a not-similar font,” says Dr. Bush, who is also president of the WSMA.

But for many patients meeting credentialed and noncredentialed health care professionals, that kind of transparency is lacking since not all facilities require badges that show degrees. As team care becomes increasingly the norm, patients are seeing an array of health care professionals for their treatment. Some of them are physicians, and some are not. But how is a patient to tell the difference? In fact, it’s not always simple. Allied health professionals often provide care that was formerly primarily provided by physicians.

“Patients deserve to have an appropriate understanding of who is taking care of them,” says Dr. Bush. “Surveys show people are confused about the credentials of the people providing their care.”

Indeed, surveys by the American Medical Association conducted over the past 10 years underscore just how confused patients are. Among the findings in a 2024 survey:

• 24% of respondents misidentified nurse practitioners as medical doctors, while only 71% correctly indicated that they were not medical doctors.
• 48% of respondents misidentified those with a doctor of nursing practice as a medical doctor, while only 39% correctly indicated that they were not a medical doctor, and 13% said they did not know.
• 22% of respondents misidentified physician assistants as a medical doctor, while only 70% correctly indicated that they were not a medical doctor.

Despite this confusion, AMA surveys show patients consistently express that when their health or the health of their loved ones is at stake, they want transparency and physicians to be involved in their care.

Thanks to a grant from the AMA Scope of Practice Partnership, the WSMA is working on a creative solution to respond to patient concerns. For the state legislative session that kicked off this month, the WSMA has prepared a measure that would require health care professionals to disclose their health care credential or provider type on their name badge if they are providing care in a clinical setting. The measure would also require health care professionals to list their credentials and titles in advertising.

“Similar laws in other states have helped improve transparency and ensure that health care professionals clearly identify their qualifications, giving patients accurate information about who is providing their care and empowering them to make informed decisions,” says AMA Board Chair David H. Aizuss, MD. “Addressing issues like this is central to the mission of the AMA’s Scope of Practice Partnership, and this grant represents an important investment in advancing WSMA’s advocacy.”

“Title transparency means different things to different physicians,” says Alex Wehinger, associate director of legislative advocacy for the WSMA. “We tried to find an avenue that is positive for transparency. The bill language does not take a prohibitive approach, but is focused more on disclosure of credentials, because there are more health care professions and license types in the health care system.”

Wehinger notes that this is not a new issue. A transparency bill was unsuccessful in the Legislature in 2013. “This has been on the minds of our physician members for many years,” she says.

Indeed, the AMA has been conducting a “truth in advertising” campaign for more than a dozen years. The campaign’s goals are to ensure truth and transparency in health care, including requiring all health care professionals to clearly identify their education, training, and licensure to patients, among other provisions. To date, all or part of the model bill has been adopted by 25 states.

With the continued expansion of team-based care, the issue has become even more urgent. The current problem is the result of the changing nature of health care delivery. To address the problem of the shortage of physicians, nonphysician professionals began to take on nonspecialized treatment of patients. Their numbers have grown substantially over time.

“Twenty years ago, you knew when you were going to see your primary care professional that it was an MD,” says Dr. Bush. “Now, my primary care provider is a nurse practitioner. That’s the case for thousands of people.”

In fact, the numbers confirm the dramatic change in the makeup of credentialed health care professionals. According to the National Center for Health Workforce Analysis, in 2022 there were 279,194 primary care physicians in the U.S. That same year, there were an estimated 270,660 nurse practitioners delivering primary care. Yet, in one AMA survey, which covered a period up until 2018, 88% of patients thought a primary care provider was an MD.

As important as the growth of health professionals to supplement the work of physicians has been, it has also created a problem around medical title transparency. In the rush of treatment, patients may not know the credentials of the people treating them and what those credentials allow.

Some specialties have been grappling with the issue for years. For example, while ophthalmologists have a medical degree and are either MDs or DOs, many people commonly refer to optometrists as “eye doctors.” Rather than medical degrees, optometrists hold doctor of optometry degrees. The American Society of Anesthesiologists has objected to an effort by nurse anesthetists to use the title “nurse anesthesiologist,” even though the word “anesthesiologist” refers to someone with a license to practice medicine.

WSMA’s proposed legislation is intended to prevent patient confusion in a rapidly changing health care landscape. Wehinger stresses that the goal of legislation is not directed at any group of health care professionals. “This is a patient transparency focus,” she says.

Indeed, says Dr. Bush, the main purpose of the legislation is to make it clear in the clinical setting what each health care professional’s credentials are. “The number one piece of this legislation is badging in health care settings,” she says. “Normally, that’s taken on a case- by-case basis in each institution, but this would make it a more uniform standard so that patients could go into any health care setting and know who is taking care of them.”

Dr. Bush emphasizes that the legislation wouldn’t affect how health care professionals refer to themselves. “It’s not about who can call themselves what,” she says. “It’s about transparency in licensing and training.”

As with badges, the advertising component of the legislation will help patients understand who is providing care so that they can make informed decisions. “There are a lot of different clinics that are providing various types of health care, for depression, chronic pain, or lifestyle modifications,” Dr. Bush points out. “It’s important for transparency in that advertising so that patients know the education and licensing of those providing the service.”

While transparency is the focus of the proposed legislation, Dr. Bush notes that safety is also an important consideration. “It is important on a safety level, especially for the less-regulated areas of health care,” she points out. “Knowing levels of education and training can help patients ensure their own safety.”

Ultimately, says Dr. Bush, the legislation should be an opportunity for professionals to show their patients the hard work and dedication that went into their training. “It should be a matter of pride for every level of care,” she says. “Everyone has different licensure and training. We should celebrate those differences and what we bring together as a team to take care of patients.”

John Gallagher is a freelance writer specializing in health care.

This article was featured in the January/February 2026 issue of WSMA Reports, WSMA’s print magazine.